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The 4 different benefits of Medicare’s Annual Wellness Visits

Expert on revenue potential for (AWV) Medicare Annual Wellness Visits, Daniel Bluestein, MD, CMD and is a primary care physician. He had something to say about things you the physician should know to maximize this specific visit for both your practice and your patient.

  1. This is different and better than a normal physical.

An AWV gives an opportunity to coordinate care and have a talk proactively about the patient “as a whole.” Especially their current health conditions and medical family history. Discuss medications and supplements. Providers can obtain specific vitals as height and weight, body mass index, their blood pressure and vision. Then discuss and recommend different screenings and vaccinations needed.

  1. This pays the practice back

The AWV can be a reimbursement that is over and above standard office visits Current Procedural Terminology CPT codes and has additional perks as well says Bluestein.

When necessary a provider may add a significant, management service code that is separately identifiable evaluation and from the same physician and on the same day of that procedure or other service when applicable.

Wellness visits are golden opportunities have discussion about extremely important topic such as advanced care planning or referrals to any community-based health resources when applicable.

There are value-based reimbursement programs that include calls used for documenting quality improvement and conduct of practice improvement projects and the vehicle used for meeting these stipulations is the wellness visit.

  1. It’s investing in your support success

Bluestein says at his office it found using internal polling that most patients never heard about the AWV but wanted it once they did. Historically patients who take advantage of the AWV is very low and some reports showed percentages as low as 14.5% of eligible Part B “fee for service” beneficiaries used this service to their advantage.

Patients need to “have an understanding” of the visit and that it’s not the time to come in for a sore knee. Patients need to be reminded that in there first year of Part B eligibility they can have the initial AWV. Then in the second year of eligibility there will be an ongoing subsequent AWV. There may be other charges for lab draws, immunizations, etc. but the visit itself is covered 100% by Medicare.

  1. Providing quality time with patients

This is the opportunity for the clinicians to spend 40 to 60 minutes of quality time with a patient. Conversations can lead to an open exchange of information where patients might disclose additional problems requiring follow up care in which the practice can bill for. Remember initial visits or follow ups may be accomplished by the physician as well as the physician assistant or nurse practitioner, medical professionals, team supervised directly by the physician.

Remember; Annual wellness visits may result in the reduction and duration of more serious problems for a patient later.


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